Prescription omega-3 fatty acid products: considerations for patients with diabetes mellitus

Tajuddin, Nadeem; Shaikh, Ali; Hassan, Amir

doi:10.2147/dmso.s97036

Cited by 15 publications

(7 citation statements)

References 64 publications

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“…Several mechanisms may explain the favourable associations between n -3 fatty acids and the risk of CVD. Previous clinical trials looking at intermediate cardiovascular outcomes among people with diabetes have reported that n -3 fatty acid supplementation could lower triacylglycerol concentrations [ 35 , 36 ], improve arterial blood flow and attenuate inflammatory signals [ 37 , 38 ]. These effects were supported by clinical trials in the general population and in experimental studies [ 39 – 41 ].…”

Section: Discussionmentioning

confidence: 99%

Plasma fatty acids and the risk of vascular disease and mortality outcomes in individuals with type 2 diabetes: results from the ADVANCE study

Oda

Sattar

Würtz³

et al. 2020

Diabetologia

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Aims/hypothesis This biomarker study aimed to quantify the association of essential and other plasma fatty acid biomarkers with macrovascular disease, microvascular disease and death in individuals with type 2 diabetes. Methods A case-cohort study (N = 3576), including 654 macrovascular events, 341 microvascular events and 631 deaths during 5 years of (median) follow-up, was undertaken as a secondary analysis of the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled Evaluation (ADVANCE) study (full details of the study design and primary endpoints of the ADVANCE trial and its case-cohort have been published previously). This current study considers new data: fatty acids measured from baseline plasma samples by proton NMR analysis. The fatty acids measured were n-3, docosahexaenoic acid (DHA), n-6, linoleic acid, and polyunsaturated, monounsaturated and saturated fatty acids. HRs were modelled per SD higher (percentage) fatty acid. C statistics and continuous net reclassification improvement were used to test the added value of fatty acids compared with traditional cardiovascular risk factors. Results After adjustment for traditional cardiovascular risk factors, an inverse association was observed for n-3 fatty acids and DHA with the risk of macrovascular events (HR [95% CI]: 0.87 [0.80, 0.95] and 0.88 [0.81, 0.96], respectively, per 1 SD higher percentage), and for n-3 fatty acids with the risk of death (HR 0.91 [95% CI 0.84, 0.99] per 1 SD higher percentage). Such associations were also evident when investigating absolute levels of fatty acids. There were no statistically significant associations between any fatty acids and microvascular disease after adjustment. However, there was limited improvement in the predictive ability of models when any fatty acid was added.

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Section: Discussionmentioning

confidence: 99%

Plasma fatty acids and the risk of vascular disease and mortality outcomes in individuals with type 2 diabetes: results from the ADVANCE study

Oda

Sattar

Würtz³

et al. 2020

Diabetologia

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show abstract

“…Evidence specifically pertinent to patients with diabetes is relatively sparse. Clinical trials looking at intermediate cardiovascular disease outcomes among adults with diabetes have consistently reported that marine n-3 supplements could lower triglyceride concentrations,45 improve arterial blood flow, and ameliorate inflammatory conditions that predispose cardiovascular disease events 4647 Meanwhile, a secondary analysis of the JELIS study found that eicosapentaenoic acid supplementation (1.8 g/day) for 4.6 years led to a 22% reduction in risk of coronary artery disease among 4565 adults with type 2 diabetes or impaired glucose metabolism,48 but this effect was not observed in another randomized controlled trial (0.9 g/day) with a larger sample size (n=12 536) and longer follow-up (6.2 years) 49.…”

Section: Discussionmentioning

confidence: 99%

Dietary fats and mortality among patients with type 2 diabetes: analysis in two population based cohort studies

Jiao

Liu

Shin

et al. 2019

BMJ

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ObjectiveTo assess the association of dietary fatty acids with cardiovascular disease mortality and total mortality among patients with type 2 diabetes.DesignProspective, longitudinal cohort study.SettingHealth professionals in the United States.Participants11 264 participants with type 2 diabetes in the Nurses’ Health Study (1980-2014) and Health Professionals Follow-Up Study (1986-2014).ExposuresDietary fat intake assessed using validated food frequency questionnaires and updated every two to four years.Main outcome measureTotal and cardiovascular disease mortality during follow-up.ResultsDuring follow-up, 2502 deaths including 646 deaths due to cardiovascular disease were documented. After multivariate adjustment, intake of polyunsaturated fatty acids (PUFAs) was associated with a lower cardiovascular disease mortality, compared with total carbohydrates: hazard ratios comparing the highest with the lowest quarter were 0.76 (95% confidence interval 0.58 to 0.99; P for trend=0.03) for total PUFAs, 0.69 (0.52 to 0.90; P=0.007) for marine n-3 PUFAs, 1.13 (0.85 to 1.51) for α-linolenic acid, and 0.75 (0.56 to 1.01) for linoleic acid. Inverse associations with total mortality were also observed for intakes of total PUFAs, n-3 PUFAs, and linoleic acid, whereas monounsaturated fatty acids of animal, but not plant, origin were associated with a higher total mortality. In models that examined the theoretical effects of substituting PUFAs for other fats, isocalorically replacing 2% of energy from saturated fatty acids with total PUFAs or linoleic acid was associated with 13% (hazard ratio 0.87, 0.77 to 0.99) or 15% (0.85, 0.73 to 0.99) lower cardiovascular disease mortality, respectively. A 2% replacement of energy from saturated fatty acids with total PUFAs was associated with 12% (hazard ratio 0.88, 0.83 to 0.94) lower total mortality.ConclusionsIn patients with type 2 diabetes, higher intake of PUFAs, in comparison with carbohydrates or saturated fatty acids, is associated with lower total mortality and cardiovascular disease mortality. These findings highlight the important role of quality of dietary fat in the prevention of cardiovascular disease and total mortality among adults with type 2 diabetes.

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“…Insulin sensitivity seems to increase after supplementation of n-3 PUFAs in relation to non-esterified fatty acid reduction [ 27 ]. EPA and DHA prescription for Type 2 diabetes mellitus significantly reduces the levels of triglyceride known to be responsible for fat accumulation, thereby reducing the risk of developing hypertriglyceridemia [ 28 ]. However, the EPA-only prescription seems slightly better as it does not increase the concentration of low-density lipoprotein cholesterol, decreases total cholesterol levels, and results in fewer gastrointestinal effects than DHA-only prescription [ 28 ].…”

Section: Polyunsaturated Fatty Acids and Human Healthmentioning

confidence: 99%

“…EPA and DHA prescription for Type 2 diabetes mellitus significantly reduces the levels of triglyceride known to be responsible for fat accumulation, thereby reducing the risk of developing hypertriglyceridemia [ 28 ]. However, the EPA-only prescription seems slightly better as it does not increase the concentration of low-density lipoprotein cholesterol, decreases total cholesterol levels, and results in fewer gastrointestinal effects than DHA-only prescription [ 28 ]. Interestingly, these n-3 PUFA-reinforced diets do not result in glucose metabolism impairment in diabetic patients, as shown in 14 clinical trials [ 29 ].…”

Section: Polyunsaturated Fatty Acids and Human Healthmentioning

confidence: 99%

Microalgae n-3 PUFAs Production and Use in Food and Feed Industries

Remize¹,

Brunel²,

Silva³

et al. 2021

Marine Drugs

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N-3 polyunsaturated fatty acids (n-3 PUFAs), and especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are essential compounds for human health. They have been proven to act positively on a panel of diseases and have interesting anti-oxidative, anti-inflammatory or anti-cancer properties. For these reasons, they are receiving more and more attention in recent years, especially future food or feed development. EPA and DHA come mainly from marine sources like fish or seaweed. Unfortunately, due to global warming, these compounds are becoming scarce for humans because of overfishing and stock reduction. Although increasing in recent years, aquaculture appears insufficient to meet the increasing requirements of these healthy molecules for humans. One alternative resides in the cultivation of microalgae, the initial producers of EPA and DHA. They are also rich in biochemicals with interesting properties. After defining macro and microalgae, this review synthesizes the current knowledge on n-3 PUFAs regarding health benefits and the challenges surrounding their supply within the environmental context. Microalgae n-3 PUFA production is examined and its synthesis pathways are discussed. Finally, the use of EPA and DHA in food and feed is investigated. This work aims to define better the issues surrounding n-3 PUFA production and supply and the potential of microalgae as a sustainable source of compounds to enhance the food and feed of the future.

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Prescription omega-3 fatty acid products: considerations for patients with diabetes mellitus

Cited by 15 publications

References 64 publications

Plasma fatty acids and the risk of vascular disease and mortality outcomes in individuals with type 2 diabetes: results from the ADVANCE study

Plasma fatty acids and the risk of vascular disease and mortality outcomes in individuals with type 2 diabetes: results from the ADVANCE study

Dietary fats and mortality among patients with type 2 diabetes: analysis in two population based cohort studies

Microalgae n-3 PUFAs Production and Use in Food and Feed Industries

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